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Sunday, September 03, 2006

YRBSS Item Overview

Introduction The Youth Risk Behavior Surveillance System (YRBSS) recognizes health behavior that contributes to the leading causes of mortality, morbidity, and social problems is often established early in life. To identify, treat, and prevent these diseases/conditions it is necessary to understand underlying behavioral patterns. By tracking the risk behavior of youth, it is possible to target prevention strategies to appropriate age group, gender, and population; identify co-existing risk factors; and determine life-time risk.YRBSS OverviewPriority Risk Behaviors YRBSS priority risk behaviors include tobacco use, alcohol and other drugs, sexual behavior, dietary behavior, physical activity, and other behavior resulting in intentional or unintentional injuries. Main Goals Three main goals have been identified in formulating the YRBSS:1. Assess how risk behaviors change with age.2. Provide baseline data for youth and adult populations.3. Focus on behaviors identified as primary causes of morbidity and mortality.Survey Methodology In order to collect usable data, the YRBSS was divided into two major sections; the school based YRBSS and the household based YRBSS. In 1995, the national, state, and local school based YRBSS was conducted on 10, 904 ninth through twelvth grade students; it was anonymous, and used self-administered questionnaires. The same format is used to conduct a biennial survey. A second component of the school based survey: The National College YRBSS is designed similar to the grade school survey but targeted to college aged youth. The household based YRBSS is composed of 12 to 21 year old youth in or out of school. It uses a national sample of households; is confidential; uses an audio tape for administration of the questionnaire, and was last conducted in 1992. Data is linked to other data collected in the household.Specific Data Needs Each component of the YRBSS addresses specific data collection needs including:1. Monitoring of progress towards National Health Promotion and Disease Prevention Objectives.2. Monitoring of progress towards the National Education Goal #7 – Safe, Disciplined, Drug-Free Schools.3. Monitoring of progress towards the American Cancer Society’s measure of success for comprehensive school health education.4. Focusing on school health education teacher training and instructional programs.5. The support of comprehensive school health programs.Health Promotion and Disease Prevention The major emphasis of the Health Promotion and Disease Prevention goals is contained in the Healthy People 2000 program. Healthy People 2000 was adopted by the U.S. Department of Health and Human Services in 1990 in order to:1. Increase the span of healthy life for Americans.2. Reduce health disparities among Americans.3. Achieve access to preventive services for all Americans (CDC, 1997).To achieve these goals, 22 priority areas were identified with 300 specific objectives set. The Healthy People 2000 Consortium is composed of 330 member organizations. Each priority area is overseen by a lead Public Health Service (PHS) agency. Because the YRBSS is a surveillance system, it falls under priority area #22. However, because it is comprehensive in scope, it also is relevant to many other priority areas by providing baseline data and establishing clear statistical objectives. As a surveillance system, the YRBSS study is guided by year 2000 objectives for all surveillance systems under the supervision of the CDC. These objectives include:? Develop and implement common health status indicators? Create national data sources to track year 2000 objectives? Develop and disseminate among Federal/State/local agencies procedures for collecting comparable data for the year 2000 objectives? Improve related data for minority populations? Expand state-based activity to track year 2000 objectives? Provide timely processing of survey and surveillance data (CDC, 1998).National Education Goals National Education Goals focus on providing a safe, disciplined, and drug-free school environment for children. Violence and drugs are a top priority area with model programs established throughout the nation. The District of Columbia serves as the National Model City for the project. Activities such as research, program development and evaluation; data collection; public awareness; training and technical information; and dissemination of information constitute the majority of work in this area. The YRBSS supports these efforts by providing baseline data and statistical support for documentation of changes brought about by various intervention methods. The YRBSS also provides guidance regarding areas most in need of service, tracks the effectiveness of given programs in relation to others; and provides cost analysis data.American Cancer Society’s Measure of Success The YRBSS also tracks progress towards the American Cancer Society’s measure of success for comprehensive school health education. According to the ACS, the goal of the National Health Standards is to improve educational achievement of students, improve overall health in the United States, and support the goals of Healthy People 2000. The National Health Standards for students identified by the ACS include:1. Comprehension of concepts related to health promotion and disease prevention.2. Demonstrated ability to access valid health information and health-promoting products and services.3. Demonstrated ability to practice health enhancing behavior and reduce health risks.4. The ability to analyze the influence of culture, media, technology, and other factors on health.5. Demonstrated ability to use interpersonal communication skills to enhance health.6. Demonstrated ability to use goal-setting/decision making skills to enhance health.7. Demonstrated ability to advocate for personal, family and community health. (ACS, 1998).School Health Programs and Teacher Training Specific needs governing school health programs and teacher training is identified from the YRBSS survey and objectives set forth in the preceding three goals. For example, HIV/AIDS education is a top priority for both students and instructors. Data from the YRBSS indicate objectives set forth by Healthy People 2000 will be more effective if addressed at the school level. Most students receive HIV/AIDS training in school, therefore, school-based education has demonstrated a high level of impact. On the other hand, teachers are often ill-prepared to teach HIV/AIDS curriculum resulting in the need to “train the trainer”. This is just one example of YRBSS data used to implement policy and programming efforts.Current Findings The following represent findings of the YRBSS priority areas.Tobacco? 71.3% of students have smoked cigarettes.? 16.1% smoke frequently.? 11.4% use smokeless tobacco.? White students are significantly more likely to smoke than minority students.? Male students were significantly more likely to smoke than female students.Drugs and AlcoholIn the previous 30 days:
? Over 50% of students had at least one drink.? Over 32.% had five or more drinks on at least one occasion.? Over 25% had used marijuana.? Over 03% had used cocaine.
Lifetime usage:? Over 42% had used marijuana.? 7% had used cocaine.? 4.5% had used crack or freebase.? 3.7% used illegal steroids.? 2% had injected illegal drugs.Sex, Pregnancy, STD’s and HIV? Over 50% of all high school students have had sexual intercourse.? 46% of students did not use a condom during their last sexual encounter.? 83% of students reported they or their partner did not use birth control pills prior to their last sexual encounter.? Over 86% received HIV prevention education in school.? Approximately 25% of all new HIV infections, 25% of new STD’s, and one million pregnancies occur each year among teenagers.Diet and Physical Activity? 72% reported eating less than 5 servings of fruits/vegetables during the previous day.? 39% at more than 2 servings of high fat foods in the previous day.? 41% were attempting weight loss.? 05% took laxatives or vomited to lose or maintain weight.? 40% were not enrolled in physical education classes.? 30% exercised less than 20 minutes during the average physical education class.? 36% did not participate in regular vigorous physical activity.? 79% did not participate in regular moderate physical activity.
Intentional and Unintentional Injuries? Over 38% of students had been in a physical fight within the last year.? Over 4% had received medical treatment for injuries sustained in a fight during the last year.? Approximately 24% had contemplated suicide during the previous year with over 17% making specific plans for attempting suicide.? 2.8% of students had made a suicide attempt during the previous year that required medical attention.In Conclusion The YRBSS was designed to provide baseline data for Healthy People 2000 objectives for both children and adults; support school health initiatives; demonstrate priority areas; track success/failure rates of interventions, etcetera. This massive undertaking is a surveillance/data system with implications for numerous branches of health delivery and education. Emphasis is on the behavioral aspects of disease/injury risk. In the future, tracking the increased incidence and prevalence of high risk behavior in youth with on-set of disease or injury will assist in identifying lifetime risk potential. Closely related to this is the identification of educational and training needs for school aged children and programming designed to enhance protective factors among high at risk populations.


ReferencesAmerican Cancer Society. http://www.cancer.org/Centers for Disease Control and Prevention. http://www.cdc.gov/ERIC Clearinghouse on Teaching and Teacher Education. http://www.ericsp.org/National Institute of Health. http://www.publicinfo@nlm.nih.govOffice of Disease Prevention and Health Promotion. http://www.osophs.dhhs.gov/

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